Opioid analgesics (e.g., morphine, methadone, hydrocodone, oxycodone, hydromorphone, fentanyl, oxymorphone, codeine, etc.) are one of the most widely abused classes of prescription medications. These medications are known to be dangerous, and put users at risk for adverse health effects, among the most concerning of which are the complications of overdose, including death. These risks are increased exponentially when the medications are misused, such as when taken along with alcohol.
Excessive alcohol consumption also accounts for a significant health burden, and is common among groups that report high rates of prescription drug abuse. And when taken with opioids, it is well-established that alcohol increases central nervous system depression and the risk for overdose. Despite these known risks, patients exhibit very high rates of non-adherence with medical recommendations to avoid alcohol consumption when taking opioid medications. In fact, per estimates from the National Institute of Drug Abuse (NIDA), roughly 21-29% of patients prescribed opioids for chronic pain misuse them, and a large proportion of this misuse relates to co-administration of these medications with alcohol.
To quantify alcohol involvement in opioid medication-related deaths, and to inform prevention efforts, the U.S. Center for Disease Control and Prevention (CDC) recently analyzed data for drug-related deaths that involved opioids and alcohol in 13 states. The analysis showed that alcohol was involved in 22.1% of opioid drug-related deaths. These data are highly consistent with an analysis which evaluated the prevalence and characteristics of opioid-related deaths involving alcohol in Ontario, Canada, which showed that approximately 20% of fatal opioid overdoses involved alcohol. Similarly, another recent analysis showed that Americans with chronic non-cancer pain managed with opioids and a previous diagnosis of alcohol abuse or dependence had 5 times the rate of opioid overdose, 2.3 times the rate of accidents, and 1.2 times the rate of injury, as well as higher all-cause health care costs.
Based on these and other data, the CDC recently concluded that interventions to reduce the abuse of alcohol in conjunction with opioid medications are needed. However, the current standard of care for prevention of co-administration of alcohol with opioids is limited to patient counseling and random urine drug testing, which as evidenced by the data outlined above, represents an ineffective measure. A more definitive solution for preventing co-administration of alcohol with opioid medications is therefore essential for enhancing the safety of these inherently dangerous medications.